Into Week 2

We're now starting week two here at Stanford.  Clayton has done really well recovering from surgery, but, as with many Fontans, chest drainage has become the main issue.  Last week the drainage had been on a slow but steady decrease; however, it has been increasing over the last few days.  Because Clayton is losing so much fluid from his chest, he's needing some replacement fluids and albumin infusions.  This has necessitated IV access, which has been difficult to maintain.  Last night it was decided that he was definitely in need of a PICC (peripherally inserted central catheter), which is a very long IV that is threaded through his arm, all the way into a major vessel leading into the superior vena cava.  These lines are supposed to last a long time (sometimes up to months), and they are hardier, meaning you can infuse things that tend to burn up tiny veins. 

So, unfortunately small children require anesthesia for the procedure, and in order to receive the anesthesia they wanted, Clayton needed a working IV.  Three different people came in to try throughout last night with zero success.  At about noon Clayton was moved to the CVICU for the procedure.  The PICC team was able to place an IV, give the necessary anesthesia, place the PICC, and remove the new IV.  Then Clayton was transferred back up to 3 West.  I'm sad it took so much poking for people to realize Clayton needed a PICC, but it's over and done with, and now we're moving on.  Hopefully this line will last for a while.  Please pray this line doesn't become infected.  We've never escaped an open heart surgery without a central line infection, and they can turn really ugly, really fast, so we really, really want this line to stay clean.

As for Clayton's drainage, now that they're infusing some replacement fluids, it's not unheard of for the drainage to increase.  The drainage is coming from his vascular system, and the more you pump in, the more you'll probably leak out, but they don't want him to become depleted on different vitamins, nutrients, and minerals of the blood, so he must be infused.  Drainage after Fontan follows no real pattern.  Some kids have it, some don't.  Sometimes it lasts for a few days, sometimes several months, and there's no real agreed upon way to treat it.  Waiting it out is the only thing we can really do.

We'll just have to wait and see how long this process takes.  So far the fluid has been clear (no chylothorax, PRAISE THE LORD), but that can rear its ugly head anytime, so pray for Clayton to stay chylo-free please.  Also, Clayton has chest tubes, multiple healing scars and scabs, as well as the PICC.  We're praying he can stay infection free.  For some reason, hospitals are dirty places with all kinds of nasty bugs that are easy to catch.  Please continue to pray for his health.